| NPI | 1194167049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MI 4301109950) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09095100) |
| 208C00000X Colon & Rectal Surgery (Licence: FL ME116260) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME116260) | |
| Enumeration Date | 2013-07-20 |
| Last Update Date | 2016-06-20 |